EP1617781A4 - Accessoire d'implant dentaire - Google Patents

Accessoire d'implant dentaire

Info

Publication number
EP1617781A4
EP1617781A4 EP04757595A EP04757595A EP1617781A4 EP 1617781 A4 EP1617781 A4 EP 1617781A4 EP 04757595 A EP04757595 A EP 04757595A EP 04757595 A EP04757595 A EP 04757595A EP 1617781 A4 EP1617781 A4 EP 1617781A4
Authority
EP
European Patent Office
Prior art keywords
fixture
dental fixture
implant
abutment
dental
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Withdrawn
Application number
EP04757595A
Other languages
German (de)
English (en)
Other versions
EP1617781A2 (fr
Inventor
Carl W Schulter
Gary Qi
Andrew J Schulter
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Cagenix Inc
Original Assignee
Cagenix Inc
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Cagenix Inc filed Critical Cagenix Inc
Publication of EP1617781A2 publication Critical patent/EP1617781A2/fr
Publication of EP1617781A4 publication Critical patent/EP1617781A4/fr
Withdrawn legal-status Critical Current

Links

Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61CDENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C8/00Means to be fixed to the jaw-bone for consolidating natural teeth or for fixing dental prostheses thereon; Dental implants; Implanting tools
    • A61C8/0048Connecting the upper structure to the implant, e.g. bridging bars
    • A61C8/0075Implant heads specially designed for receiving an upper structure
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61CDENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C8/00Means to be fixed to the jaw-bone for consolidating natural teeth or for fixing dental prostheses thereon; Dental implants; Implanting tools
    • A61C8/0048Connecting the upper structure to the implant, e.g. bridging bars
    • A61C8/005Connecting devices for joining an upper structure with an implant member, e.g. spacers
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61CDENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C8/00Means to be fixed to the jaw-bone for consolidating natural teeth or for fixing dental prostheses thereon; Dental implants; Implanting tools
    • A61C8/0048Connecting the upper structure to the implant, e.g. bridging bars
    • A61C8/005Connecting devices for joining an upper structure with an implant member, e.g. spacers
    • A61C8/0066Connecting devices for joining an upper structure with an implant member, e.g. spacers with positioning means
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61CDENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C8/00Means to be fixed to the jaw-bone for consolidating natural teeth or for fixing dental prostheses thereon; Dental implants; Implanting tools
    • A61C8/0048Connecting the upper structure to the implant, e.g. bridging bars
    • A61C8/0077Connecting the upper structure to the implant, e.g. bridging bars with shape following the gingival surface or the bone surface
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61CDENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C8/00Means to be fixed to the jaw-bone for consolidating natural teeth or for fixing dental prostheses thereon; Dental implants; Implanting tools
    • A61C8/0018Means to be fixed to the jaw-bone for consolidating natural teeth or for fixing dental prostheses thereon; Dental implants; Implanting tools characterised by the shape
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61CDENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C8/00Means to be fixed to the jaw-bone for consolidating natural teeth or for fixing dental prostheses thereon; Dental implants; Implanting tools
    • A61C8/0048Connecting the upper structure to the implant, e.g. bridging bars
    • A61C8/005Connecting devices for joining an upper structure with an implant member, e.g. spacers
    • A61C8/0054Connecting devices for joining an upper structure with an implant member, e.g. spacers having a cylindrical implant connecting part
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61CDENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C8/00Means to be fixed to the jaw-bone for consolidating natural teeth or for fixing dental prostheses thereon; Dental implants; Implanting tools
    • A61C8/0048Connecting the upper structure to the implant, e.g. bridging bars
    • A61C8/005Connecting devices for joining an upper structure with an implant member, e.g. spacers
    • A61C8/006Connecting devices for joining an upper structure with an implant member, e.g. spacers with polygonal positional means, e.g. hexagonal or octagonal
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61CDENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C8/00Means to be fixed to the jaw-bone for consolidating natural teeth or for fixing dental prostheses thereon; Dental implants; Implanting tools
    • A61C8/0048Connecting the upper structure to the implant, e.g. bridging bars
    • A61C8/005Connecting devices for joining an upper structure with an implant member, e.g. spacers
    • A61C8/0069Connecting devices for joining an upper structure with an implant member, e.g. spacers tapered or conical connection

Definitions

  • This invention relates to dental implant fixtures.
  • Implants are used as replacements for missing teeth. Implants are typically in the form of a fixture that is coupled to an abutment.
  • the fixture portion of a dental implant is that portion which extends into the maxilla or mandible, where it is anchored in a bone in the maxilla or mandible.
  • the fixture typically includes a top portion that extends out of the maxilla or mandible and provides an anchoring point for an abutment.
  • the abutment portion of a dental implant is the portion that is fixed to the fixture and extends above the gingiva. It has an upper surface that is configured to receive and support a crown.
  • Microgaps between the fixture and the abutment are one cause of this loss of bone.
  • the fixture is often positioned within the maxilla or mandible such that its upper surface is below the gingiva.
  • an abutment is fixed to the fixture, there is a tiny gap between the abutment and the fixture that is at least partially disposed beneath the gingiva.
  • This microgap becomes a haven or reservoir for oral bacteria.
  • the gingiva may become irritated or infected, and the bond between the fixture and the maxilla or mandible weakened. Loosening may also be caused by the poor distribution of forces from the implant to the maxilla or mandible.
  • this stress concentration may cause the bond between fixture and maxilla or mandible to weaken. Stress concentrations are typically caused by improper fixture design or positioning, or a fixture that is not shaped to distribute the tooth load relatively evenly. [0005] Another problem often encountered with implants is the failure of the crown that is attached to the abutment. Large loads placed on the crown when chewing cause the crown to fatigue and ultimately to fracture. These large loads can also weaken the cement that bonds the crown to the abutment if the crown-to-abutment joint design unduly concentrates the load.
  • a dental fixture including an elongate lower portion having a lower end and an upper end, and configured to be inserted into a maxilla or mandible; and a flaring upper portion having a lower end and an upper end, said lower end being coupled to the upper end of the lower portion.
  • FIGURES 1-7 are perspective, top, right-side, front, left-side, rear and bottom views of a unitary right central mandibular incisor implant.
  • FIGURES 8-14 are perspective, top, right-side, front, left-side, rear and bottom views of a unitary right lateral maxillar incisor implant.
  • FIGURE 15 is a cross-section of both of the implants of FIGURES 1-14 at any of cross-sections A- A, B-B, and C-C.
  • FIGURE 16 is an alternative cross-section of any of the implants of FIGURES 1-14 showing a faceted outer surface and taking at sections A-A, B-B, and C-C.
  • FIGURE 17 is a cross-section of either of the implants of FIGURES 1-14 taken at section line D-D.
  • FIGURE 18 is a cross-section of any of the implants of FIGURES 1-14 taken at section line E-E.
  • FIGURE 19A is a fragmentary front view of any of the implants of the foregoing figures showing how the flare angle measured at the sides of the implant increases as one travels upward along the shaft of the implant.
  • FIGURE 19B similarly illustrates how the flare angle increases as one travels upward along the implant as measured on the front side of the implant.
  • FIGURE 20 is a top view of any of the foregoing implants illustrating the narrow band having a Width that extends circumferentially around the entire implant.
  • FIGURE 21 is a fragmentary rear view of any of the foregoing implants showing a local minima (low point) of the narrow band extending around the implant that is located on the center of the back side of the implant.
  • FIGURE 22 is a fragmentary side view of any of the foregoing implants showing the local minima at the rear of the implant and a slightly higher local minima at the front of the implant, as well as the two imaginary planes 142 and 144 that define the front portion and rear portion of the narrow band.
  • FIGURE 23 is a fragmentary front view of any of the foregoing implants showing the local minima at the front center of the implant.
  • FIGURE 24 is a top view of any of the foregoing implants showing the numeral 3- node configuration of both the lower portion of the implant and the upper portion of the implant and also illustrating how each of the three (3) nodes of the upper portion of the implant are disposed immediately adjacent to each of the three (3) nodes of the lower portion of the implant.
  • FIGURES 25 A-25D illustrate top, side, rear and bottom views of an alternative upper abutment portion of the implant that can be employed together with an alternative form of the lower portion of the implant shown in FIGURES 26A-26C.
  • FIGURES 26A-26C are top, side, and rear views of an alternative lower portion of the implant that may be coupled together with the upper portion shown in FIGURES 25A-25D to form a two-piece implant having the identical structure, configuration, arrangement, dimensions, features, and capabilities as the implants described in the foregoing FIGURES with one (1) difference: the implant is made of two pieces coupled together by a cylinder extending downward from the upper portion in FIGURES 25A-25C into the cylindrical recess shown in FIGURES 26A-26C.
  • FIGURE 26D is a partial cross-sectional left side view of the implant formed by coupling the implant upper portion or abutment of FIGURE 25A-25D and the implant lower portion illustrated in FIGURES 26A-26C in which a cylindrical portion of the upper portion extending downward therefrom is received in a matching cylindrical hole in the top of the lower portion shown in FIGURES 26A-26C held together by a screw recessed into the top of the upper portion, extending through the upper portion, and threadly engaged with mating internal threads disposed in the upper part of the lower portion of the implant.
  • FIGURE 27 is an alternative cross-sectional profile of the cylinder of the upper portion of the implants in FIGURES 25A-25D and the cylindrical hole in the lower portion of the implant shown in FIGURES 26A-26C illustrating a triangular sharp-edged protrusion that extends the length of the cylinder in place of the existing protrusion 214 and corresponding recess or slot 190.
  • FIGURE 28 illustrates an alternative cross-section of the cylinder and cylindrical hole of the foregoing figures showing the protrusion and recess as a three-sided trapezoidal shape.
  • FIGURE 29 is yet another alternative profile of the cylinder and cylindrical recess of foregoing figures showing the protrusion and slot as a rectangular (preferably square) shape extending outward from the cylinder.
  • FIGURE 30 illustrates an alternative profile of the cylinder and cylindrical hole in the foregoing figures in which the protrusion and recess of those figures has been removed and the cylinder (and cylindrical hole) faceted with longitudinally extending facets that extend the length of the cylinder and cylindrical hole. Facets shall mean flat planar surfaces.
  • FIGURE 31 is an alternative profile of the cylinder and cylindrical hole in the foregoing figures showing the position of the protrusion and the slot reversed: the cylinder extending downward from the upper portion of the implant has a hemispherical slot and the cylindrical hole in the lower portion of the implant has an inwardly extending hemispherical protrusion.
  • FIGURES 32-45 illustrate the upper portion and the lower portion of a two-piece implant intended to be used in place of an upper cuspid having the same mating construction as that described above with regard to FIGURES 25-31 wherein FIGURES 32-38 are perspective, top, right-side, front, left-side, rear, and bottom views of the upper portion of the implant and FIGURES 39-45 are perspective, top, right-side, front, left-side, rear, and bottom views of the lower portion into which the upper portion is inserted.
  • FIGURES 46-59 illustrate the upper and lower portion of a two-piece implant intended for use as a lower cuspid in which FIGURES 46-52 are perspective, top, right-side, front, left-side, rear, and bottom views of the upper portion of the implant and further wherein FIGURES 53-59 are perspective, top, right-side, front, left-side, rear and bottom views of the lower portion of the implant.
  • FIGURES 60-73 illustrate the upper and lower portions of a two-piece implant intended for use as a first lower pre-molar, wherein FIGURES 60-66 are perspective, top, right- side, front, left-side, rear and bottom views of the upper portion of the implant and FIGURES 67-73 are perspective, top, right-side, front, left-side, rear and bottom views of the lower portion of the implant.
  • FIGURES 74-87 illustrate an alternative two-piece implant intended for use as a first upper pre-molar implant, in which FIGURES 74-80 illustrate perspective, top, right-side, front, left-side, rear and bottom views of the upper portion of the implant and FIGURES 81-87 illustrate perspective, top, right-side, front, left-side, rear, and bottom views of the lower portion of the implant.
  • FIGURES 88-101 illustrate the upper and lower portions of a two-piece implant intended to replace a lower molar, in which FIGURES 88-94 illustrate perspective, top, right- side, front, left-side, rear, and bottom views of the upper portion of the implant and FIGURES 95-101 illustrate perspective, top, right-side, front, left-side, rear, and bottom views of the lower portion of the implant.
  • FIGURES 102- 115 illustrate an alternative two-piece implant intended to be used as an upper molar, wherein FIGURES 102-108 are perspective, top, right-side, front, left-side, rear, and bottom views of the upper portion of the implant and FIGURES 109-115 illustrate perspective, top, right-side, front, left-side, rear and bottom views of the lower portion of the implant.
  • teeth or implants directly face the adjacent teeth or implants.
  • “Front” as used with reference to a tooth or implant refers to that portion that faces outward away from the maxilla or mandible and often refe ⁇ ed to as facial.
  • “Rear” as used with reference to a tooth or implant refers to that portion of the tooth or implant that faces the inside of the mouth and often referred to as lingual.
  • “Sides” can be either mesial or distal depending upon whether they face toward the dental mid-line or away from the dental mid-line, respectively.
  • CEJ cement-enamel junction
  • CRJ coronal-root junction
  • a "facial CRJ line” (also “frontal CRJ line”) refers to an imaginary line extending across the face of a mandible or maxilla that passes through the front and lowermost portion of the CRJ of each tooth or implant in the mandible or maxilla. Since the mandible and maxilla each have a row of teeth, there are two facial CRJ lines - one wrapping around the outside of maxilla and one wrapping around the outside of the mandible.
  • a "lingual CRJ line” refers to an imaginary line extending across the face of a maxilla or mandible that passes through the rear and lowermost portion of the CRJ of each tooth or implant in the maxilla or mandible. Since the maxilla and mandible each have a row of teeth, there are two lingual CRJ lines - one extending along the inside of the maxilla and one extending along the inside of the mandible.
  • the "center" of a two dimensional shape shall mean the location on that two-dimensional body where the first moment of area equals zero.
  • the "mirror plane” as that term is used herein is a plane that extends vertically through the implant from top to bottom, and extending front-to-back from the lingual side to the facial side of the implant. Each illustrated implant has a mirror plane.
  • implants illustrated and described herein are all configured for use on the right side of the mandible and maxilla.
  • the claims are intended to cover not only implants on the right side, but those on the left side as well.
  • Non-illustrated implants for the left side of the mandible and maxilla would be identical in construction to those on the right side, but exist in mirror image form, mirrored about the mirror plane of each implant.
  • the features, capabilities and construction of each implant on the left side of the mouth (being of identical mirrored construction to those on the right side) are identical to the corresponding implant on the right side of the mouth.
  • FIGURES 1-7 illustrate a dental implant.
  • the implant is a generally elongate member, with a lower portion or fixture 100 that is configured to be embedded or implanted in a maxilla or mandible, and an upper portion or abutment 102 that extends out of the maxilla or mandible and provides a structure on which a dental prosthesis 104 such as a crown, (colloquially called a "cap” and illustrated in FIGURES 3-6), bridge or framework can be attached.
  • a dental prosthesis 104 such as a crown, (colloquially called a "cap” and illustrated in FIGURES 3-6), bridge or framework can be attached.
  • the crown 104 (which is illustrated as a dashed line) surrounds the upper portion of the implant, providing a smooth outer surface to simulate a natural tooth.
  • the crown 104 extends above the marginal gingiva 106 (dashed) and preferably slightly below the gingiva.
  • Dental implants are generally provided either in one or in two pieces.
  • one piece we mean that the implant is a single integral body that is made to be implanted in a maxilla or mandible as a single unit, with an upper portion extending upward away from an out of the gingiva.
  • a two-piece implant such as those shown in FIGURES 25 A et. seq. is made of two portions, the upper portion being generally referred to as the abutment and the lower portion being generally referred to as the fixture.
  • the abutment and fixture are coupled together, typically by a threaded fastener, and typically after the fixture has been implanted.
  • a “fixture” includes at least that portion of a dental implant that is inserted into a maxilla or mandible, or otherwise embedded in bone when in use.
  • An “abutment” includes at least that portion of a dental implant that is configured to be coupled to and support a crown.
  • fixtures and abutment arrangements in which the fixture and abutment are formed as a single unit. Examples include the one-piece implants illustrated in Figures 1- 24. Thus, the terms “abutment” and “fixture” should not be interpreted as requiring a single piece dental implant.
  • FIGURES 1-7 is a single piece implant, having an integrated abutment and fixture. It is intended for use as a lower central and lateral incisor. A similar single piece implant can be seen in FIGURES 8-14. It is intended for use as an upper lateral incisor.
  • the description herein regarding the implant of FIGURES 1-7 applies equally to the implant of FIGURES 8-14 except where specifically noted as being applicable only to the implant of FIGS. 1-7 or the implant of FIGS. 8-14.
  • FIGURE 15 illustrates cross-sections of the fixtures or lower portions 100 of the implants FIGURES 1-15 taken at cutting lines A- A, B-B, and C-C. These sections are sections through the lower portion 100 of the fixture.
  • the preferred cross-sectional shape 108 as shown in FIGURE 15 is circular. Each section in the lower portion of the fixture preferably has the same diameter or the same cross-sectional area.
  • the lower section of the fixture and between cutting lines A-A, B-B, and C-C can have an irregular cross section, however, such as an oval or a polygon.
  • the polygonal shape can be regular or irregular.
  • the polygonal shape can have radiused corners.
  • the polygon can be an convex or concavo-convex polygon.
  • FIGURE 16 illustrates a regular convex polygon and cross-section 108a having ten sides. The number of sides is not critical, however, although a range of between 6 and 15 are preferred.
  • the gaps between the outer surface of the polygon and the circular drilled hole in which the fixture is inserted can be filled with a bone growth enhancer, autograft, allograft, or cement, for example.
  • a bone growth enhancer it may help bond the fixture to the bone in which it is inserted.
  • the material is a bone growth enhancer, it may encourage bone growth between the fixture and the bone in which it is inserted, thereby providing more rapid healing and a better bond between the fixture and the bone in which it is inserted.
  • the hole maybe made by or profiled by an osteotome which preferably has an outer profile similar to the outer surface of the fixture, hi this alternative method, a drill may be used to make the initial hole and the hole may then be expanded and profiled by inserting the osteotome straight down into the hole.
  • the implants of FIGURES 1-14 have a longitudinal axis 110 that extends generally up-and-down through the length of the fixture (or lower portion 100) and through the abutment (or upper portion 102) as well.
  • This axis is defined as a line as close to the center of mass of the lower portion of the fixture as possible. Since, in the preferred embodiments shown here, the cross-sections A-A, B-B and C-C are circular, the longitudinal axis 110 goes through the center of the circular cross-sections. Were the cross-sections irregular, the longitudinal axis would pass through each cross section as close as possible to the areal center of the cross sections as possible.
  • the longitudinal axis 110 goes through the center of each cross section.
  • the lower portion 100 is not bent or curved, but is substantially straight (although the outer surface may taper in the shape of a flaring horn) along the length of the longitudinal axis such that the longitudinal axis extends through the center of all the cross-sections of the lower portion of the fixture 100.
  • FIGURES 17 and 18 are cross sections of the upper portion of the fixture 100. Note that the cross-sections are preferably not circular but extend irregularly, being narrower about one axis 112, than about axis 114.
  • the cross-sections of FIGURES 17 and 18 have the general cross-sectional shape of an ellipse. They are also preferably slightly flattened at one end of the major axis 112 to more accurately represent the profile of an incisor.
  • Elliptical cross-section 116 (FIG. 18), the upper cross section E-E of FIG. 5 is larger in area and has a more distinct elliptical shape than elliptical cross-section 118.
  • the major/minor axis length ratio of the ellipse 116 of FIGURE 18 is greater than the major/minor axis ratio of the ellipse 118 of FIGURE 17, which in turn is greater than the major/minor axis ratio of the circle of FIGURE 15.
  • the ratio of FIGURE 15 is unity, since the cross-section shown in FIGURE 15 is a circle.
  • the major/minor axis ratio preferably (and therefore pictured here as) ratio of FIGURE 17 (preferably 1.05-1.25) is between that of FIGURE 15 (1.000) and FIGURE 18 (preferably 1.15-1.30).
  • the load provided by the abutment can be more equally distributed to the lower portion of the fixture and then to the mandible or maxilla.
  • the maxilla or mandible and the abutting mucosal tissue will better surround the implant in a contour that more closely resembles the bone contour of a natural, undamaged when the bone heals.
  • the gingiva which covers the bone will more closely imitate the original gingiva giving the patient a smile that is more regular, lifelike, and symmetric.
  • the upper portion 101 of the fixture 100 is circular in cross-section, it is believed that bone will not heal along the natural bone contour. This could make the bone-to-implant junction weaker, and the gingiva more asymmetric and displeasing to the eye.
  • a gap is provided on either side of the fixture that gives the gingiva more room to grow between adjacent teeth or fixtures and to better surround the base of the tooth.
  • the upper portion 101 of the fixtures 100 of FIGURES 1-14 preferably has this irregular cross-sectional shape wider in the facial-lingual direction and narrower in the mesial- distal direction (see FIGURES 17 and 18), it should be understood that an irregular shape is not essential. Indeed, any cross-sectional shape, such as the circular and regular polygonal shapes described above as possibilities for the lower portion of the fixture (see FIGURES 15 and 16) are equally useful for the upper portion 101 of the fixture as well.
  • the lower portion of the fixture 100 is preferably circular and has a constant cross section as one moves up the fixture.
  • the upper portion 101 of fixture 100 has a cross-section that is preferably non-circular and elongate in a fore-and-aft direction.
  • the cross- sections of the upper portion 101 of the fixture 100 are preferably elliptical and preferably increase in cross-sectional area and irregularity (or out-of-roundness) as one moves up the upper portion of the fixture.
  • the cross-sectional area of each successive cross-section of the upper portion of the fixture preferably increases and makes the fixture surface flare outward. This gives a greater and greater flare angle the farther one goes upward along the upper portion 101 of the fixture 100.
  • FIGURES 19A and 19B illustrate this.
  • FIGURE 19A is a partial front and FIGURE 19B is a partial side view of the implant of FIGURES. 1-7 showing the upper portion of the fixture.
  • the flare angle of the outer surface or wall of the fixture is shown in three (3) locations 120, 122, and 124 along the longitudinal axis, where location 122 is above location 120 and location 124 is above location 122.
  • the flare angle 0 at position 120 is preferably between 1 and 3 degrees. Traveling up the upper portion 101 of the fixture, the flare angle 0 at position 122 is preferably 2 and 5 degrees. Traveling even further up the upper portion of the fixture, the flare angle 0 at position 124 is preferably between 4 and 8 degrees.
  • FIGURE 19B the flare angle between the front wall of the upper portion of the fixture and the longitudinal axis is illustrated.
  • the flare angle 0 at location 120 is preferably between 3 and 8 degrees.
  • the flare angle 0 at location 122 along the longitudinal axis is preferably between 6 and 12 degrees.
  • the flare angle 0 at location 124 along the longitudinal axis of the fixture is preferably between 10 and 25 degrees.
  • the flare angles of the back wall of the fixture are similar to those of the front wall at each location 120, 122, and 124 flare angle at the front and back of the fixture is greater than the flare angles at each side of the fixture.
  • FIGURE 15 is regular: a circle.
  • FIGURES 17 and 18 are less regular and niore elliptical, with their area distributed farther from the center (or centric) of the area of the lower cross-sections A-A, B-B, C-C (FIGURES 15 and 17).
  • Another prefe ⁇ ed characteristic of the fixture is the increasing normalized second moment of area of each of the fixture's successive cross-sections about the centroid of each said successive cross-section, as one progresses from cross-sections at the bottom of the upper portion of the fixture to and through successive cross-sections near or at the top of the upper portion of the fixture.
  • the second moment of an area (such as the cross-sections through the fixture) about a centric of that area is the sum over the entire area of each constituent infinitesimal area times the square of the distance of that infrmtesi ⁇ ial area from the centroid of the overall area.
  • the second moment of area is calculated about an axis that passes through the centroid of the cross-sectional area and is parallel with the longitudinal axis of the fixture.
  • a normalized second moment of a (cross-sectional) area is the second moment of that (cross-sectional) area divided by the second moment of a circular disk having the same area as that (cross-sectional) area.
  • the normalized second moment of the cross-sectional area of FIGURE 15 is one (1.0) since the actual cross-section of FIGURE 15 is a circular disk, and the longitudinal axis passes through the center.
  • the normalized second moment of area of the circular cross-section 108 is the second moment of a circle having the area of cross-section 108 divided by the second moment of a circle of the same area. Since the preferred and illustrated cross-sections A-A, B-B, and C-C are already circles, the numerator and the denominator are the same, and therefore the ratio of second moments is one, regardless of the actual area of the circular cross-section of FIGURE 15.
  • the normalized second moments of area of the cross-sections of FIGURES 17 and 18 are greater than one (1.0). Furthermore, the normalized second moment of area of the cross-section of FIGURE 18 is greater than that of the cross-section of FIGURE 17.
  • the normalized second moment of area preferably increases as one moves upward through successive cross-sections of the upper portion of the fixture, as explained immediately above. It is also preferable that this increase in normalized second moment is continuous and unbroken as one moves upward through the fixture.
  • continuous and unbroken we mean that successive cross-sectional areas of the upper fixture's cross-sections meet the requirement that their normalized second moment (as described above) is greater than the normalized second moment of the cross-section immediately below, and is smaller than that of the cross-section immediately above.
  • FIGS. 19A and 19B show how the outer surface of the fixture flares at four different locations around its periphery at three successively higher longitudinal positions 120, 122, and 124. Note that the flare angle increases at different rates depending upon the location around the periphery or circumference of the fixture.
  • rate of flare means the rate al which the flare angle increases per unit of distance traveled upward along the longitudinal axis of the fixture.
  • the flare angle of the side walls of the upper portion of the fixture change from 0 1 equals 2 degrees at location 120 to 02 equals 3.5 degrees at location 122. This gives a rate of increase of the side wall flare angle of 1.5 degrees over the distance traveled from location 120 to locationl22.
  • the flare angle is 04 equals 4.5 degrees and at location 122, the flare angle is 0 5 equals 9 degrees.
  • the rate of change of the flare angle as one travels from location 120 to location 122 along the longitudinal axis of the fixture is 9 degrees minus 5.5 degrees or 3.5 degrees. This is greater than the 1.5 degrees increase in flare angle measured along the side wall of the fixture as shown in FIGURE 19 A.
  • Locations 120, 122 and 124 are spaced equally far apart. Thus, depending on one's position around the periphery of the upper portion of the fixture at a particular position along the longitudinal axis, the flare angle varies and the rate of change of the flare angle (the rate of flare) varies as well.
  • FIGURES 2 and 9 are top views of the fixtures of FIGURES 1-14 showing how the tops of the fixtures preferably extend radially outward away from the base of the abutment, preferably face upward and define a narrow band 126 that extends outward away from the lower portion of the abutment and generally perpendicular to axis 110.
  • This narrow band 126 is preferably not circular in plane view, but instead has an irregular outer profile such as the elliptical profile shown in the cross-sections D-D and E-E of FIGURES 1-14.
  • the width ("W" in FIGURE 20) of the narrow bands 126 i.e. their extent in the radial direction - - the directions perpendicular to axis 110) is preferably constant as one travels around the periphery of the fixture and preferably measures between 0.25 mm and 1 mm.
  • the top of the fixtures intended for different tooth positions along the mandible preferably have different contours, each contour mimicking the contours of the tooth that is being replaced since the shape of the upper portion of the fixture in the mouth may have different contours.
  • the contours of this narrow band preferably vary from implant to implant depending upon the location along the mandibles.
  • band As one follows the band around the circumference of the fixture the path described by band preferable rises and falls — it moves up and down along the longitudinal axis of the implant. By “rising” we mean that it moves upward. By “falling”, we mean that it moves downward.
  • each implant has two local minima located at the front and the back of the implant, and two local maxima located at both sides of the implants. Looking at the implants in a direction perpendicular to the implant's longitudinal axes, such as the views shown in FIGURES 21-23, one can see a preferred relative relationship of the local minima with respect to the longitudinal axis. Note that the highest points on the band are the two local maxima 134 and 135 located on either side of the band. The front local minima 138 is below the two local maxima 134 and 135 and the rear local minima 130 is below the front local minima 138.
  • the narrow band 126 preferably defines a planar surface or a plurality of intersecting planar surfaces. As best shown in the side view of FIG.22, the band 126 defines two imaginary planes 142 and 144 that intersect at the upper maxima 134 and 135.
  • the intersecting planes 142 and 144 intersect, they are, by definition, at an angle to one another. They are also preferably at an angle to the longitudinal axis 110. As shown in FIGURE 22, the plane 144 defining the front half of the narrow band 126 is preferably at an angle alpha of between 5 and 15 degrees with respect to the longitudinal axis. More preferably it is at an angle of between 7 and 30 degrees.
  • angles are the angles between the plane and the longitudinal axis as it would appear when projected into a view normal to the longitudinal axis, which in this embodiment is the side view.
  • the other intersecting plane 142 defines the rear half of the narrow band 126 of the incisor implants of FIGURES 1-15. It, too, is preferably at an angle with respect to the longitudinal axis.
  • the angle beta is preferably between 10 and 50 degrees. More preferably it is between 15 and 40 degrees. Even more preferably, it is between 20 and 55 degrees.
  • angles are the angles between the rear plane and the longitudinal axis as it would appear when projected into a view normal to the longitudinal axis, which in this embodiment are the side views.
  • the abutment or upper portion 102 of the implants of FIGURES 1-14 preferably tapers inwardly (i.e. toward axis 110) from the base as the abutment extends upward away from the fixture. Successive cross-sections of the abutment (by a plane perpendicular to axis 110) get smaller and smaller in area as one moves upward along the longitudinal axis 110 from the base 150 of the abutment 102 to the top 152 of the abutment. See, for example, FIGURES 21-23.
  • the base 150 of the abutment adjacent to the fixture is preferably one continuous curved surface 154 extending circumferentially around the implant. Surface 154 is tapered inwardly toward the longitudinal axis as it moves upward, having a smaller and smaller cross-sectional area.
  • the base 150 of the abutment where the abutment meets the fixture 100 is preferably disposed radially inward around the entire circumference of the implant. It is this inward spacing of the abutment away from the edge of the top of the fixture that defines the narrow band 126 described in greater detail above.
  • the base 150 of the abutment preferably has a cross-sectional shape similar to that of the fixture to which it is coupled.
  • the implants of FIGURES 1-14 have fixtures with upper surfaces and cross-sections that are generally flattened ellipses and hence have major and minor axes.
  • the abutments that extend upward from these fixtures have cross-sections similar to the top portions of the fixture to which they are coupled. They also are preferably flattened ellipses.
  • a “node”, as the term is used here, describes local protrusions of curvilinear shapes (e.g. regions wherein the circumferential periphery of the implant has a reduced radius of curvature or regions where the periphery curves more sharply).
  • the three nodes (the three local minima) on the flattened ellipse 159 defined by base of the abutment are identified as items 160, 162 and 164.
  • 162 and 164 are 166, 168 and 170.
  • nodes 160, 162 and 164 of the abutment are aligned with corresponding nodes 166, 168 and 170 of the fixture as best seen in FIG. 24.
  • the nodes of each fixture and its corresponding abutment are distributed at the same angular locations around the longitudinal axis of the implant.
  • node 168 is disposed at 40 degrees
  • node 170 is disposed at 180 degrees
  • node 166 is disposed at 320 degrees.
  • node 162 is disposed at 35 degrees
  • 164 is disposed at 180 degrees
  • node 160 is disposed at 325 degrees.
  • FIGURES 3-6 illustrate a preferred orientation of an exemplary implant and its associated prosthesis, shown as crown 104.
  • the implant shown in FIGURES 3-6 shows a preferred coupling of an implant and a crown.
  • the crown 104 extends around and completely covers the free portion of the abutment - e.g. the free outer surface of the abutment extending above the top of the fixture.
  • the lower portion of the crown abuts the fixture, more particularly, the surface of narrow band 126.
  • junction created by the lower portion of the crown 104 abutting the narrow band is smooth.
  • the junction is configured to provide a smooth transition from the crown to the fixture, and vice versa.
  • the fixture and the abutment are unitary structures, formed integrally, or formed individually and coupled together to one another before implantation in the maxilla or mandible. For most applications, however, it is desirable to create a multi-piece device having an abutment and fixture that are separate and removably attachable.
  • a doctor is enabled to implant a fixture, to wait for the fixtures and bone to heal, and to then attach an abutment and crown to the fixture.
  • This delayed assembly permits a fixture to heal before a tooth load is applied. If the entire implant, both fixture and abutment, was installed initially, the patient could only with great difficulty avoid biting down on the implant while the bone heals. Biting forces applied to an implant, especially during the initial fixtures/bone healing phase, can prevent proper healing.
  • the implants of the following figures are all two-piece implants in which the abutment and the fixture are separate and are coupled together after the fixture is embedded in a patient's bone and permitted to heal.
  • the abutment and fixture are held together with a screw, and have interengaging binding surfaces that prevent rotation of the abutment with respect to the fixture.
  • FIGURES 25A-26D show preferred structures that couple the abutment and the fixture.
  • FIGURES 26A-26C show the fixture portion of a two-piece implant in top, side, and rear views, respectively.
  • Exemplary fixture 180 has a hole 182 that extends axially down the middle of the fixture to a depth of between 3 and 10 mm.
  • This hole is a right circular cylinder and has internal threads 184 that are configured to engage a screw (FIGURE 26D) that extends through the abutment (FIGURES 25A-25D) into the fixture.
  • An upper portion 186 of the hole is a right circular cylinder and has a larger diameter than the lower threaded portion 188 of the hole.
  • This upper portion also has an anlirotation structure 190, here shown as a half-circle slot that is formed in the wall of the upper portion of the hole 182. This slot defines a surface that interengages with the abutment to prevent the abutment and the fixture from rotating with respect to each other.
  • Slot 190 is preferably shaped as an arc of circle as viewed from above and as best shown in FIGURE 26 A.
  • the transition between the slot 190 and the upper portion 186 is preferably rounded or radiused.
  • the diameter of the upper portion 186 of hole 182 is preferably between 1.2 and 1.7 larger than the diameter of the lower threaded portion 188 of hole 182.
  • the upper portion 186 of the hole may have a constant diameter, or it may be tapered inward the farther one goes down upper portion 186 to have a smaller and smaller cross-sectional area. If tapered, the taper angle (the angle between the longitudinal axis of the hole and the wall of the upper portion) is preferably between 1 and 10 degrees.
  • the upper surface 192 of the fixture is generally planar, in the form of two intersecting planes 194 and 196. These planes join together at a line 198 that extends across the top of the fixture from one side to another, dividing the top of the fixture into two portions of generally equal area.
  • line 198 that extends across the top of the fixture from one side to another, dividing the top of the fixture into two portions of generally equal area.
  • the abutment 200 has a central hole 202 that extends entirely through the abutment. This hole is slightly larger in diameter than the threads of the screw (FIGURE 26D) designed to mate with threaded hole 188 in the fixture.
  • the upper portion 204 of central hole 202 has a larger diameter than the lower portion 206 of central hole 202.
  • the bottom 208 of the upper portion 204 defines a planar surface 210 that is configured to receive and support the head 203 of the screw 205 (FIGURE 26D) that holds the abutment and fixture together.
  • a cylinder 214 extends downward from the bottom surface 216 of the abutment. This cylinder is configured to fit inside the upper portion 186 of the hole 182 in the fixture.
  • the cylinder 214 is preferably a right circular cylinder, although it may have a taper matching that of the upper portion of the hole in the fixture.
  • Cylinder 214 includes an arcuate projection 215 generally the same in size and orientation as the arcuate slot 190 in the fixture.
  • Figure 26D is a partial cross-section of the abutment and fixture of figures 25A-25D and 26A-26C, showing how they are fixed together by screw 205.
  • Cylinder 214 is inserted into upper portion 186 of hole 182.
  • the head 203 of screw 205 is configured to enter the upper portion 204 of abutment hole 202 and preferably to be received entirely therein such that it does not extend above upper surface 212 of abutment 200.
  • the lower surface 216 of the abutment 203 from which the cylinder 214 downwardly extends is in the form of two intersecting planes 218 and 220. These planes are preferably at the same angles with respect to one another and with respect to axis 110 as are planes 194, 196, respectively that form the top of the fixture such that when the fixture and abutment are coupled together, plane 218 abuts and is generally coplanar with plane 194 and plane 220 abuts and is generally coplanar with plane 196.
  • Plane 218 and plane 194 are preferably parallel, as are planes 220 and 196.
  • the angle between planes 194 and 196 on the fixture is the same as the angle between planes 218 and 220 on the abutment.
  • the planes 194 and 196 that define the top of the fixture have a greater overall area than the overall area of planes 218 and 220 that define the bottom of the abutment.
  • the planes 194 and 196 defining the top of the fixture extend radially outward beyond the planes 218 and 220 that define the bottom of the abutment.
  • This portion of planes 194 and 196 extending beyond the bottom of the abutment define a narrow band 126 that extends around the implant.
  • This narrow band 126 that extends outward from the junction of the abutment and the fixture that is formed by the planar top surface of the fixture preferably has the same characteristics, extent and orientation as the narrow band 126 described as part of the single piece implant of FIGURES 1-24.
  • arcuate projection 215 on the abutment's cylinder that mates with one arcuate slot 190 in the fixture's hole more may be provided, such as two, three, four, five, six, seven, or even more.
  • the slot/proj ection pairs that engage with each other to prevent rotation of the abutment with respect to the fixture are preferably arranged equiangularly about the longitudinal axis of the implant. For example, if there are two such slot/projection pairs, they are preferably disposed at 180 degrees with respect to each other about the longitudinal axis. If there are three, they are preferably located at 120 degrees with respect to each other. If there are four pairs, they are preferably disposed at 90 degrees, and so on.
  • the slots and projections may be polygonal, for example triangular (FIG. 27), trapezoidal (FIG.28), or rectangular (FIG. 29).
  • the cylinder (and the hole that receives) it may be faceted, defining mating surfaces with longitudinally extending interengaging facets that provide the anti-rotation feature of the mating slots and projections (FIG. 30). If faceted, the facets on the cylinder and in the hole in which it is inserted preferably define a regular polygon when viewed along the longitudinal axis of the implant.
  • the circular cylindrical hole and mating cylinder need not be circular, but can be ovoid, elliptical, or have any other smooth curvilinear irregular surface that assists in preventing rotation of the abutment with respect to the fixture.
  • the cylinder whether extending downward from the abutment, or alternatively extending upward from the fixture, need not have protruding surfaces that engage slots or grooves on the hole.
  • the protrusions or projections 215 may be provided on the inner surface of the hole, extending inwardly, and the slots or groves to which they are mated may be provide on the outer surface of the cylinder. See FIG. 31, for example. In short, the slots 190 and projections 215 may be reversed. Any of the above arrangements and configurations of the mating surfaces of the abutment and the fixture can be combined to provide additional anti- rotation capability.
  • FIGURES 32-59 illustrate two-piece implants that are preferred as replacement for cuspids.
  • FIGURES 32-45 illustrate a preferred replacement implant for an upper (i.e. maxillary) cuspid 500 and
  • FIGURES 46-59 illustrate a preferred implant for a lower (i.e. mandibular) cuspid implant 502.
  • the cuspid implants are preferably two piece implants, as illustrated herein, and have coupling structures such as those shown in FIGURES 25-31, described above. While they are illustrated as two-piece implants, they may also be provided in single piece form. In single piece form, they would have the identical structural characteristics, capabilities and features as the two piece upper central incisor implant shown in FIGURES 25-31, but would lack the coupling feature (i.e., the holes, cylinders and screws) of FIGURES 25-31.
  • each of the two piece fixtures of FIGURES 32 et seq. preferably have the same illustrated and alternative coupling structures as described above in conjunction with FIGURES 25A-31.
  • the angle 300 of the planar top 302 of abutment 102 through which hole 202 passes is 135 to 165 degrees with respect to the longitudinal axis 110 of the implant for the upper cuspid and 180 to 150 degrees with respect to the longitudinal axis 510 of the implant for the lower cuspid.
  • FIGURES 60-73 illustrate a two-piece implant that is preferred as replacement for first lower premolars (FLP).
  • FIGURES 60-66 illustrate the abutment portion 102 and
  • FIGURES 67-73 illustrate the fixture portion 100.
  • Abutment 102 has an upper surface 302 that unlike the prior examples is not a flat plane, but is a compound concave convex surface as shown in the side view of FIGURE 64.
  • a lower portion of surface 302 is disposed at an angle 300 with respect to longitudinal axis 110 of 120 degrees.
  • An upper portion of surface 302 is disposed at an angle 300 prime with respect to longitudinal axis 110 of 160 degrees.
  • An upper portion 304 of surface 302 is concave.
  • a lower portion 306 of surface 302 is convex.
  • FIGURES 74-87 illustrate a two-piece implant that is preferred as a replacement for first upper premolars (FUP).
  • FIGURES 74-80 illustrate the abutment 102 portion of the implant and
  • FIGURES 81-87 illustrate the fixture 100 portion of the implant.
  • Abutment 102 has an upper surface 310 that defines 2 local maxima 312 and 314 and 2 local minima 316 and 318. These are arranged such that the 2 maxima 312 and 314 are generally aligned with and extend along the fore-and-aft axis 320 and the 2 minima 316 and 318 are disposed along the orthogonal side to side axis 322.
  • fore-and-aft refers to an axis extending from the lingual side to the labial side of the implant and side to side refers to an axis extending perpendicular to that direction along the mandible or maxilla toward adjacent teeth.
  • upper surface 300 of abutment 102 is convex.
  • the lowerportion 159 of abutment 102 as seen in plan view (FIGURE 75) is convex-concave. It generally has a kidney shape with one side wall 324 that is concave.
  • the lower portion 159 of abutment 102 has four nodes 326, 328, 330, and 332 generally disposed at the four corners of the abutment with two nodes 330 and 332 facing outward on the labial side and two nodes 326 and 328 facing inwards on the lingual side of the abutment.
  • Side wall 324 changes from concave at a lower portion 334 of the side wall to convex at an upper portion 336 of the side wall.
  • Abutment 100 similarly has an upper surface 161 that is concavo-convex in plan view (FIGURE 82).
  • Surface 161 has four nodes 338, 340, 342, and 344 that are disposed about longitudinal axis 110 in the same angular orientation as corresponding nodes 330, 328, 326, and 332, respectively.
  • an upward wall portion 346 is concave and is angularly disposed with respect to longitudinal axis 110 in the same location as concave portion 334 of surface 324 of abutment 102 shown in FIGURE 74-80.
  • Nodes 338 and 334 face outwardly on a labial wall of the fixture 100 and nodes 340 and 342 face inwardly (lingually) on the opposing side of abutment 100.
  • Top surface 161 of abutment 100 has a kidney shape oriented in the same manner as the kidney shape lower portion 159 of abutment 102.
  • the fixture concavity and the abutment concavity are preferably disposed one above the other at the same angular location and on the same side of the implant.
  • the concavity is on the right side of the implant.
  • the right side of the implant is also the side of the implant closes to the front of the mouth. It is the side of the implant that, when inserted, will face and abut either the first upper cuspid or a first upper cuspid implant.
  • the shape of the concavity is preferably sized to receive a portion of the convex side of the adjacent cuspid. In this manner, the concavity permits the cuspid and the first premolar to be fitted together more closely, with a convex sidewall of the cuspid tooth or implant nested inside the concavity of the first upper premolar.
  • FIGURE 82 includes a dashed line 350 that shows the position of lower portion 159 of abutment 102.
  • the space between line 350, the outer most extent of the lower portion of the abutment and upper edge 352 of fixture 100 defines the narrow band 126 in this example.
  • narrow band 126 when projected in the top view (FIGURE 82) is concavo-convex and includes an indented or concaved portion 354 unlike the preceding examples.
  • FIGURES 88-101 illustrate a two-piece implant that is preferred as a replacement for lower molars (LM).
  • FIGURES 88-93 illustrate the abutment 102 portion, and
  • FIGURES 94-101 illustrate the fixture 100 portion.
  • the LM implants have four nodes 360, 362, 364, and 366 at the top of the fixture 161, four corresponding nodes 368, 370, 372, and 374 at the bottom 159 of the abutment 102. These nodes oil the abutment are angularly aligned with the nodes on the fixture at the bottom of the abutment, and at the top of the abutment. These four nodes are disposed at four angular locations measured in a circumferential direction with respect to the longitudinal axis 110 of the LM implant.
  • the rounded corners of the abutment 102 that define the nodes typically extend upward and tilt slightly inward, as shown in the FIGURES, to make a four-sided generally pyramidal structure.
  • the abutment may be a polygonal (preferably quadrilateral and more preferably trapezoidal) pyramidal cylinder with rounded corners, as shown herein.
  • Each face of the pyramidal shape 383, 382, 384, and 386 is a sidewall of the abutment.
  • Each sidewall preferably meets at a corner. These corners where adjacent sidewalls of the abutment meet are rounded.
  • Each corner is one of the four nodes of the abutment.
  • the lingual sidewall 386 faces inward toward the tongue.
  • the facial sidewall 382 faces outward toward the face.
  • the lingual sidewall is preferably shorter than the facial sidewall.
  • the sidewalls 380 and 384 that join the lingual and facial sidewalls therefore spread apart as they extend forward from the lingual sidewall to the facial sidewall.
  • the top surface 300 while generally planar and parallel to the longitudinal axis of the implant, has four prominences or peaks 390, 392, 394, and 396 that extend upward from the top surface 300 of the abutment 102. These prominences or peaks (local maxima) are disposed one at each rounded corner of the abutment.
  • the width of the LM implant's narrow band 126 is preferably between .5 and 1 mm.
  • Inner or lingual side wall 386 of abutment 102 is preferably slightly concave, both at the top and at the bottom where it abuts the top of fixture 100.
  • Upper portion 00 of the side wall of fixture 100 is preferably also concave to the same extent as the concavity of abutment 102 thereby defining there between a slightly concave portion 402 of narrow band 126.
  • This concave portion 402 of narrow band 126 is located on the lingual side of the implant fixture 100.
  • FIGURES 102-115 illustrate a two-piece implant that is preferred as a replacement for upper molars (UM).
  • FIGURES 102-108 illustrate the abutment 102 portion of the UM implant and
  • FIGURES 109-115 illustrate the fixture 100 portion of the UM implant.
  • the UM implant have three nodes 410, 412, and 414 located at the bottom 159 of abutment 102. There are three co ⁇ esponding nodes 416, 418, and 420 that are angularly disposed about longitudinal axis 110 in the same location as co ⁇ esponding nodes 410, 412, and 414.
  • UM abutment 102 has four peaks or prominences (or maxima) that extend upward from top surface 300 of that abutment. Each of these four prominences 430, 432, 434, and 436 are spaced apart from adjacent peaks or prominences by an angle of between 70 and 120 degrees about longitudinal axis 110.

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  • Orthopedic Medicine & Surgery (AREA)
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Abstract

Un implant dentaire contient un accessoire oblong présentant des parois évasées vers l'extérieur à mesure que l'on se déplace vers le haut le long dudit accessoire et un élément d'aboutement couplé à la partie supérieure de l'accessoire et présentant des parois évasées vers l'intérieur. L'élément d'aboutement est conçu pour supporter une prothèse telle qu'une couronne. La surface supérieure de l'accessoire s'étend vers l'extérieur à partir de l'élément d'aboutement de manière à former une bande ou plate-forme étroite sur laquelle une surface inférieure de la couronne peut reposer.
EP04757595A 2003-03-18 2004-03-18 Accessoire d'implant dentaire Withdrawn EP1617781A4 (fr)

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US10/391,079 US20040185418A1 (en) 2003-03-18 2003-03-18 Dental implant fixture
PCT/US2004/008249 WO2004082504A2 (fr) 2003-03-18 2004-03-18 Accessoire d'implant dentaire

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EP1617781A2 EP1617781A2 (fr) 2006-01-25
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WO2001050972A2 (fr) * 2000-01-11 2001-07-19 Nicholas Elian Implants dentaires et systemes implant dentaire/dent artificielle
EP1205158A1 (fr) * 2000-11-10 2002-05-15 Dinkelacker, Wolfgang, Dr. med. dent. Implant dentaire
US20030031982A1 (en) * 2001-08-10 2003-02-13 Abarno Juan Carlos Split implant for dental reconstruction
USD470939S1 (en) * 2002-03-01 2003-02-25 Fereidoun Daftary Anatomic implant with a beveled edge

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WO2004082504A2 (fr) 2004-09-30
WO2004082504B1 (fr) 2005-06-16
EP1617781A2 (fr) 2006-01-25
WO2004082504A3 (fr) 2005-04-14
US20040185418A1 (en) 2004-09-23

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